HomeMy WebLinkAboutBuilding Permit #888-14 - 77 PLEASANT STREET 6/6/2014BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit No#: F?,? -
1y
Date Issued: 1 6 /' �/
IMPORTANT: Anuli
LOCATION
PROPERTY OWNER_
i
MAP S`� PARCE
-9in-AC
11
Date Received
ant must complete all items on this
Pfint
nP _
Punt a '� 10o Year Structure
- ZONING DISTRICT: Historic. District
— Machine Shop Vil
/ v• St LBD /6=•ryO\
oL
O
4
o\ ,. DR.�7ED
yes no
yes no
yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition -0
Other
$e ,tic ❑ W
ell
El Floodplain ❑Wetlands
❑ Watershed District
❑ Water/Sewer-
CV
utsc:rar i wN OF WURK TO BE PERFORMED:
Identification - Please T pe or Print Clearly
OWNER: Name: e- Phone:
ArldrinqQo 10
Contractor Name: Phone:
Addres
Supervisor's Construction License: _ .,. ----,,.Exp. Date. r_
Home Improvement License-: _ z_ _ � Exp. Date---.
ARCHITECT/ENGINEER
Phone:
Address: Reg. No.
FEE SCHEDULE: BOLDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ Q� , ° FEE: $ -�:5 R LV -31
Check No.:
S�`�� Receipt No.: -,�2, "? 6 i
NOTE: Persons contratin with u gistered contractors do not have access to the guaranty fund
$ignature..of A_gent/Owner tnnatu�a nf. cnntrartnr
I 32
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
Roofing, Siding, Interior Rehabilitation Permits
❑ Building Permit Application
❑ Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
❑ Floor Plan Or Proposed Interior Work
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
❑ Building Permit Application
❑ Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Mass check Energy Compliance Report (If Applicable)
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
❑ Building Permit Application
❑ Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
❑ Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Copy of Contract
❑ Mass check Energy Compliance Report
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submitted with the building application
Doe: Building Permit Revised 2014
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑
Tanning/Massage/Body Art ❑
Swimming Pools ❑
Well ❑
Tobacco Sales ❑
Food Packaging/Sales ❑
Private (septic tank, etc. ❑
Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT Reviewed On
COMMENTS
Signature
CONSERVATION Reviewed on Sianature
COMMENTS
HEALTH
COMMENTS
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
,Conservation Decision:
Comments
Comments
-Water & Sewer Connection/Signature & Date Driveway Permit
l
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT - Temp Dumpster on .site .yes
Located at 124 MainStreet
Fire'' Department signatureldate
r.
COMMENTS, _
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions. 49
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine
NOTES and DATA — (For department use
❑ Notified for pickup Call Email
Date Time Contact Name
i
Doc.Building Permit Revised 2014
Location
No. � - -C)- - / v
Check
27654
Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $-
Building/Frame Permit Fee $
Foundation Permit Fee $-
Other Permit Fee $
TOTAL $
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To "OFi'TOR.'ff AND OVER
0MCE of
BLUDINGDEPARTMENT
1600 DsgOodStreet-Buff ft 20 -Snite2-36
7 `++anro ��` •[5 �
�S��cHus� N•orthAudovex, Massachusetts ol845 .
GeraldA.Brown. 'I'elepl�.one(978)6$8-945
iuspeeforoi=Buildings Fax (978) 689-9542
HOMEOWNER LICENSE LXENIPTZON '
"WDINGPE S`APPLICATTOIV
pleaso prm .
-
DATE:—C&,/.z0 14 -
AM
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reetddress
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• HOMEOWNER
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Name. Horne Phone
. Work Phone
-PRESENT MAIMNG ADDRESS • : -
•
19 4s:
t Oit; Tnni,3Q
S-' • �,p Co e
The curreni exemption for "homeowners" was extended to inolude owner occupied eIli
fo allow subh homao: Tees to engage an bdividual -for lire who does notpossess a 11Ce dwellngs to i�vo units
acts as supervisor). State13uilding (Code Section 108.3.5.1) provided that the, owner
ox loss and
j DEFINITION OF HOMEOWNER
b b, a one or two auuon(s) who fa a parcel ot'land on whi oli he/she resides or intends to reside, on which there is, oris intended fo +
be, ly structures. A person who comtrocfs more that one home in a two yearper91 shall not be
considered a homeowner.
The undersigned "homedwner" assumes responsibility for compliances
Appwith the State Building Code and oilier
Applicable codes, by --laws, roles andregulatiow.
Theundersigned".homeownez" certifies that he/sheunderstands tT o Tow
minin of North A,ndoverBuilding Department
mum inspection procedures and requirements and that he/she will comply with,said procedures and
requirements,
HOMEOWNERS SIGNATURE
APPROVAL OF BUff DWG OFFICIAL
Revised 7.2009
Form Homeowners Exemptio.,
�OARl) OF APPEALS 688-9541r r `•'
• CO>tSER'� ATTON 688-9530 l3EALTH 688-9540
PLANNING 689-9555